Characterizing HIV status documentation among cancer patients at regional cancer centers in Malawi, Zimbabwe, and South Africa.

IF 3.1 2区医学 Q3 IMMUNOLOGY

Infectious Agents and Cancer Pub Date : 2023-10-26 DOI:10.1186/s13027-023-00548-1

Michalina A Montaño, Takudzwa Mtisi, Ntokozo Ndlovu, Margaret Borok, Agatha Bula, Maureen Joffe, Rachel Bender Ignacio, Maganizo B Chagomerana

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引用次数: 0

Abstract

Introduction: In East and Southern Africa, people with HIV (PWH) experience worse cancer-related outcomes and are at higher risk of developing certain cancers. Siloed care delivery pathways pose a substantial barrier to co-management of HIV and cancer care delivery.

Methods: We conducted cross-sectional studies of adult cancer patients at public radiotherapy and oncology units in Malawi (Kamuzu Central Hospital), Zimbabwe (Parirenyatwa Group of Hospitals), and South Africa (Charlotte Maxeke Hospital) between 2018 and 2019. We abstracted cancer- and HIV-related data from new cancer patient records and used Poisson regression with robust variance to identify patient characteristics associated with HIV documentation.

Results: We included 1,648 records from Malawi (median age 46 years), 1,044 records from South Africa (median age 55 years), and 1,135 records from Zimbabwe (median age 52 years). Records from all three sites were predominately from female patients; the most common cancers were cervical (Malawi [29%] and Zimbabwe [43%]) and breast (South Africa [87%]). HIV status was documented in 22% of cancer records from Malawi, 92% from South Africa, and 86% from Zimbabwe. Patients with infection-related cancers were more likely to have HIV status documented in Malawi (adjusted prevalence ratio [aPR]: 1.92, 95% confidence interval [CI]: 1.56-2.38) and Zimbabwe (aPR: 1.16, 95%CI: 1.10-1.22). Patients aged ≥ 60 years were less likely to have HIV status documented (Malawi: aPR: 0.66, 95% CI: 0.50-0.87; Zimbabwe: aPR: 0.76, 95%CI: 0.72-0.81) than patients under age 40 years. Patient age and cancer type were not associated with HIV status documentation in South Africa.

Conclusion: Different cancer centers have different gaps in HIV status documentation and will require tailored strategies to improve processes for ascertaining and recording HIV-related information in cancer records. Further research by our consortium to identify opportunities for integrating HIV and cancer care delivery is underway.

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描述马拉维、津巴布韦和南非癌症地区中心癌症患者的HIV状况文件。

简介：在东非和南部非洲，艾滋病毒感染者（PWH）的癌症相关后果更严重，患某些癌症的风险更高。孤立的护理提供途径对艾滋病毒和癌症护理提供的共同管理构成了重大障碍。方法：2018年至2019年期间，我们在马拉维（Kamuzu中央医院）、津巴布韦（Parirenyatwa医院集团）和南非（Charlotte Maxeke医院）的公共放射治疗和肿瘤科对成年癌症患者进行了横断面研究。我们从新的癌症患者记录中提取了癌症和HIV相关数据，并使用具有稳健方差的泊松回归来识别与HIV文献相关的患者特征。结果：我们纳入了1648份来自马拉维的记录（中位年龄46岁）、1044份来自南非的记录（中值年龄55岁）和1135份来自津巴布韦的记录（中位数年龄52岁）。所有三个部位的记录主要来自女性患者；最常见的癌症是宫颈癌（马拉维[29%]和津巴布韦[43%]）和乳腺癌（南非[87%]）。22%的癌症记录来自马拉维，92%来自南非，86%来自津巴布韦。在马拉维（调整后的流行率[aPR]：1.92，95%置信区间[CI]：1.56-2.38）和津巴布韦（aPR:1.16，95%可信区间：1.10-1.22），感染相关癌症患者更有可能有HIV状态记录 ≥ 与40岁以下的患者相比，60岁的患者记录HIV状况的可能性较小（马拉维：aPR:0.66，95%CI:0.50-0.87；津巴布韦：aPR=0.76，95%CI:0.72-0.81）。在南非，患者年龄和癌症类型与HIV状态记录无关。结论：不同的癌症中心在HIV状态记录方面存在不同的差距，需要有针对性的策略来改进在癌症记录中确定和记录HIV相关信息的过程。我们的联盟正在进行进一步的研究，以确定整合艾滋病毒和癌症护理的机会。

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来源期刊

Infectious Agents and Cancer ONCOLOGY-IMMUNOLOGY

CiteScore

5.80

自引率

2.70%

发文量

期刊介绍： Infectious Agents and Cancer is an open access, peer-reviewed online journal that encompasses all aspects of basic, clinical, epidemiological and translational research providing an insight into the association between chronic infections and cancer. The journal welcomes submissions in the pathogen-related cancer areas and other related topics, in particular: • HPV and anogenital cancers, as well as head and neck cancers; • EBV and Burkitt lymphoma; • HCV/HBV and hepatocellular carcinoma as well as lymphoproliferative diseases; • HHV8 and Kaposi sarcoma; • HTLV and leukemia; • Cancers in Low- and Middle-income countries. The link between infection and cancer has become well established over the past 50 years, and infection-associated cancer contribute up to 16% of cancers in developed countries and 33% in less developed countries. Preventive vaccines have been developed for only two cancer-causing viruses, highlighting both the opportunity to prevent infection-associated cancers by vaccination and the gaps that remain before vaccines can be developed for other cancer-causing agents. These gaps are due to incomplete understanding of the basic biology, natural history, epidemiology of many of the pathogens that cause cancer, the mechanisms they exploit to cause cancer, and how to interrupt progression to cancer in human populations. Early diagnosis or identification of lesions at high risk of progression represent the current most critical research area of the field supported by recent advances in genomics and proteomics technologies.